阿尔茨海黙病2ppt课件.ppt

* 这张幻灯片显示了光镜下阿尔茨海默病患者大脑皮层组织的受损情况。 可以看到两个特征性表现： 神经纤维缠结 (NFTs) 和 神经炎性 (老年)斑块(SPs). NFTs是由细胞体内的异常tau蛋白纤维构成的。NFTs损害或杀伤被他们占据的细胞。神经炎性斑块主要由 A?及其他细胞外组织的成分构成。 除了这两个特征之外，还可以观察到神经元树突数目的减少和长度的缩短。 放大倍数：x 140. * * Moderator Summary The neuronal loss that occurs in all of the four most prevalent dementias is reflected in neuroimaging investigations showing sulcal widening, ventricular enlargement and gross shrinkage at post mortem. To a certain extent, the clinical appearance of the dementia is reflected in the location of the atrophy. Alzheimers disease most affects the temporal and parietal lobes. The clinical symptoms reflect this with invariable amnesia resulting from medial temporal lobe loss, agnosias and other visuospatial difficulties due to parietal lobe loss and, to a lesser extent, language difficulties because of atrophy in the regions adjacent to the perisylvian fissure. Frontotemporal dementia syndromes affect predominantly frontotemporal regions, but there are distinct subtypes with bilateral frontal lobe involvement, asymmetrical predominantly left frontal lobe involvement in progressive non-fluent aphasia and bilateral temporal lobe involvement in fluent aphasia with visual agnosia (semantic dementia). Dementia with Lewy bodies has a distribution similar to that of AD but, invariably, there is evidence of disease in basal ganglia. Vascular dementia has a more varied distribution that is sometimes clearly within watershed areas and, in other cases, not obviously related to vascular anatomy. The clinical appearance reflects the patchy distribution of pathology. User Notes None Found * AD最早出现、最为常见的临床症状是以记忆下降为主要表现的认知功能障碍，并可能伴有精神行为症状，并导致患者的社会职业功能和日常生活能力下降。可以概括为：C—认知功能障碍(cognition)；B—精神行为异常(BPSD. Behavioral and psychological symptoms of dementia)；A—日常生活自理能力下降（ADL. activity of daily living）。 * * * * * * 上图来自于Galasko等的报告. 从左到右,每一条框都表示25% 到75% 的AD病人在1年中的最佳日常生活能力丧失相应的MMSE分数的范围. 日常生活能力的丧失与MMSE分数的减少是一致的. 可见通过测定MMSE,可以间接反映日常生活能力的情况. * * These are the symptoms most o